Scleroderma Elbow Tip Pains

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Scleroderma is a chronic condition that causes inflammation and
thickening of the skin. The cause of scleroderma is not known. Researchers have
found some evidence that genes are important factors, but the environment seems
to also play a role. This means that inheritance at least play a partial role.
It is not unusual to find other autoimmune diseases in families of scleroderma
patients. Some evidence for the role genes may play in leading to the
development of scleroderma comes from the study of Choctaw Native Americans who
are the group with the highest reported prevalence of the disease. The disease
is more frequent in females than in males.

A common area of involvement of this condition is
the skin over the tips of the elbows (the olecranon area). When this skin
is involved, it can lead to troublesome irritation of the tips of the elbows
with tenderness noted when any pressure is applied.

Recently, I saw a patient in a follow up visit who is a veterinarian with
scleroderma with this particular complication. We had been treating the
condition with a variety of topical lubricants and emollients, but to no avail.
She returned at this visit to tell me of a surprisingly successful treatment
that she had found on her own.

Bagbalm is a cream that has been used for decades to ease the irritation of
the teats of hard-working milk cows. As a veterinarian, she was aware of
this application and decided to use it regularly over the tender areas of her
elbows. Over 3 weeks she began to notice significant softening of the
tissue and remarkable improvement of the tenderness.

I have since found bagbalm helpful in others with similar complications from
scleroderma. Bagbalm is not marketed to doctors, but is readily available
in pharmacies without a prescription.